Medical manipulator and method of controlling the same

ABSTRACT

A surgery system that includes a multiple-degree freedom slave arm, which is able to be mounted with a surgical instrument and includes a plurality of joints and a plurality of motors corresponding the respective joints of the plurality of joints; a first input device configured to operate the multiple-degree freedom slave arm; a second input device configured to operate the multiple-degree freedom slave arm and different from the first input device; and a controller configured to control the multiple-degree freedom slave arm so that the multiple-degree freedom slave arm is operated by one of the first input device and the second input device.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.16/937,484, filed on Jul. 23, 2020, which is a continuation of U.S.patent application Ser. No. 16/140,049, filed on Sep. 24, 2018, now U.S.Pat. No. 11,116,533, which is a continuation of U.S. patent applicationSer. No. 14/964,696 filed on Dec. 10, 2015, now U.S. Pat. No.10,111,678, which is a continuation of International Application No.PCT/JP2013/003702 filed on Jun. 13, 2013, the entire content of all fourof which is incorporated herein by reference.

TECHNICAL FIELD

The present disclosure generally relates to a medical manipulator and amethod of controlling the same in a remote operation-type surgerysystem, and particularly relates to a medical manipulator and a methodof controlling the same suitable to support minimally invasive surgerysuch as laparoscopic surgery and laparo-thoracoscopic surgery, which areconducted by inserting a medical instrument such as an endoscope andforceps into a human body.

BACKGROUND DISCUSSION

A minimally invasive surgical operation can have numerous advantagescompared to traditional technology of laparotomy, for example, there canbe less postoperative pain, a hospital stay can be lessened, returningto normal activities (re-integration into society) can be quickened, andthere can be less damage to tissues. Meanwhile, a surgeon can berequired to have high-level techniques and considerable expertise due toconstraints such as operations, a field of vision, and surgicalinstruments. As a result, there is a strong and growing need for theminimally invasive surgical operation in which a robot surgicaloperation system capable of avoiding such constraints can be applied.

Laparoscopic surgery is a type of a minimally invasive surgicaloperation. In the laparoscopic surgery, a laparoscope and forceps areinserted into an abdominal cavity through a small incision site on anabdominal wall of a patient through the abdominal wall. An operatorconducts surgery using the forceps while observing tissues of theabdominal cavity through the laparoscope. Generally, an abdominal cavityis expanded by using carbon dioxide. In order to realize theabove-described procedure, an instrument, that is, a so-called trocar isinserted through the incision site on the abdominal wall, and thelaparoscope and the forceps are inserted into an abdominal cavity viathe trocar. In this manner, most of the surgical operation procedure canbe conducted without requiring incision for a large or open cavity in asurgical operation.

JP-T-2008-528130 discloses a remote operation-type surgery system thatcan be in operation by performing remote-operation of the forceps, whichis inserted into an abdominal cavity and carries out treatment, therebyallowing the above-described laparoscopic surgical operation to berelatively easily and safely conducted.

SUMMARY

However, in the above-described remote operation-type surgery systemincluding a plurality of arms, measures to cope with variations of atrocar position have not been taken into consideration. When the trocarposition varies, there can be a need to change the mechanical settingand physical disposition of the arms in accordance therewith, which canresult in a lack of convenience.

A remote operation-type surgery system is disclosed, which can flexiblycope with variations of an insertion port position during surgery whichis conducted by causing a medical instrument such as forceps used inlaparoscopic surgery to be inserted into a human body from an insertionport.

In accordance with an exemplary embodiment, a medical manipulator isdisclosed, which can include a multiple-degree freedom arm, which can bemounted with a medical instrument. The medical manipulator can includeretention means for retaining an insertion port position which indicatesa spatial position of an insertion port for inserting the medicalinstrument mounted in the multiple-degree freedom arm into a human body,insertion control means for controlling the multiple-degree freedom armso as to insert the medical instrument into the human body from theinsertion port position, and drive control means for driving themultiple-degree freedom arm under operational restriction in whichmovement of the medical instrument is restricted by the insertion portposition after the medical instrument is inserted from the insertionport position by using the insertion control means.

The drive control means can drive the multiple-degree freedom arm so asto move a predetermined portion of the medical instrument to spatialcoordinates instructed by a user while maintaining a state where themedical instrument passes through the insertion port position under theoperational restriction.

In accordance with an exemplary embodiment, a method is disclosed ofcontrolling a medical manipulator including a multiple-degree freedomarm, which can be mounted with a medical instrument, the methodcomprising: retaining an insertion port position which indicates aspatial position of an insertion port for inserting the medicalinstrument mounted in the multiple-degree freedom arm into a human body,in a memory; controlling the multiple-degree freedom arm so as to insertthe medical instrument into the human body from the insertion portposition; driving the multiple-degree freedom arm under operationalrestriction in which movement of the medical instrument is restricted bythe insertion port position after the medical instrument is insertedfrom the insertion port position; and driving the multiple-degreefreedom arm so as to move a predetermined portion of the medicalinstrument to spatial coordinates instructed by a user while maintaininga state where the medical instrument passes through the insertion portposition under the operational restriction.

According to the present disclosure, a remote operation-type surgerysystem can be provided, which can flexibly cope with variations of aninsertion port position for a medical instrument such as forceps and thelike with respect to a human body, for example.

In accordance with an aspect, a medical manipulator is disclosedcomprising: a multiple-degree freedom arm, which can be mounted with amedical instrument; a memory configured to retain an insertion portposition indicating a spatial position of an insertion port forinserting the medical instrument mounted in the multiple-degree freedomarm into a human body; and a controller configured to determine aninsertion posture of the medical instrument so as to cause an extendedline of a major axis of the medical instrument to pass through thespatial position indicated by the insertion port position, andconfigured to move the multiple-degree freedom arm to the determinedinsertion posture.

In accordance with another aspect, a medical manipulator is disclosedcomprising: a multiple-degree freedom arm, which can be mounted with amedical instrument; a master arm configured that an operator instructsthe multiple-degree freedom arm to make a movement of the medicalinstrument; a memory configured to retain an insertion port positionindicating a spatial position of an insertion port for inserting themedical instrument mounted in the multiple-degree freedom arm into ahuman body; an input device configured to receive an instruction by auser; a controller configured to determine an insertion posture of themedical instrument so as to cause an extended line of a major axis ofthe medical instrument to pass through the spatial position indicated bythe insertion port position based on the instruction of the user via theinput device, and configured to control the multiple-degree freedom armso as to realize the determined insertion posture; and wherein thecontroller is configured to control the multiple-degree freedom arm soas to move a distal end portion of the medical instrument to spatialcoordinates instructed by the operator via the master arm whilemaintaining a state where the medical instrument passes through theinsertion port position.

In accordance with a further aspect, a method is disclosed for aligninga medical instrument to an insertion posture by a medical manipulator,wherein the medical manipulator includes a multiple-degree freedom armwhich can be mounted with a medical instrument, and a memory, the methodcomprising: teaching an insertion port position indicating a spatialposition of an insertion port for inserting the medical instrumentmounted in the multiple-degree freedom arm into a human body; storingthe insertion port position to the memory; determining an insertionposture of the medical instrument so as to cause an extended line of amajor axis of the medical instrument to pass through the spatialposition indicated by the insertion port position; and moving themultiple-degree freedom arm to the determined insertion posture.

In accordance with an aspect, a remote operation-type surgery system isdisclosed comprising: a multiple-degree freedom slave arm, which is ableto be mounted with a medical instrument including a shaft portion and anend effector disposed at a distal end of the shaft portion; a firstinput device configured to receive a first input to operate themultiple-degree freedom slave arm; a second input device configured toreceive a second input to operate the multiple-degree freedom slave armand different from the first input device; a touch panel configured toset an operation mode for the multiple-degree freedom slave arm operatedby the second input device; and a controller configured to control themultiple-degree freedom slave arm based on the first input or secondinput, wherein the controller is configured to: determine whether or notan in-operation signal is turned on; when the in-operation signal isturned on, control the multiple-degree freedom slave arm so that themulti-degree-of-freedom slave arm performs a movement based on the firstinput by the first input device; and when the in-operation signal is notturned on, control the multiple-degree freedom slave arm so that themultiple-degree freedom slave arm performs a movement based on thesecond input by the second input device and the operation mode set bythe touch panel.

In accordance with another aspect, a method is disclosed of controllinga multiple-degree freedom slave arm which can be mounted with a medicalinstrument, the method comprising: determining whether or not anin-operation signal is turned on; when the in-operation signal is turnedon, controlling the multiple-degree freedom slave arm so that themulti-degree-of-freedom slave arm performs a movement based on a firstinput by a first input device; and when the in-operation signal is notturned on, controlling the multiple-degree freedom slave arm so that themultiple-degree freedom slave arm performs a movement based on a secondinput by a second input device and an operation mode set by a touchpanel, wherein the second input device is different from the first inputdevice.

In accordance with an aspect, a surgery system comprising: amultiple-degree freedom slave arm, which is able to be mounted with asurgical instrument and includes a plurality of joints and a pluralityof motors corresponding the respective joints of the plurality ofjoints; a first input device configured to operate the multiple-degreefreedom slave arm; a second input device configured to operate themultiple-degree freedom slave arm and different from the first inputdevice; and a controller configured to control the multiple-degreefreedom slave arm so that the multiple-degree freedom slave arm isoperated by one of the first input device and the second input device,wherein the controller is configured to: when an in-operation signal isnot turned on, allow the multiple-degree freedom slave arm to beoperated by the first input device in a teaching mode that is a mode forsetting a fulcrum position; and when the in-operation signal is turnedon, control the multiple-degree freedom slave arm so as to move a distalend portion of the surgical instrument to spatial coordinates instructedby the second input device while maintaining a state where the surgicalinstrument passes through the set fulcrum position.

In accordance with another aspect, a surgery system comprising: amultiple-degree freedom slave arm, which is able to be mounted with asurgical instrument and includes a plurality of joints and a pluralityof motors corresponding the respective joints of the plurality ofjoints; a first input device configured to operate the multiple-degreefreedom slave arm; a second input device configured to operate themultiple-degree freedom slave arm and different from the first inputdevice; a third input device different from the first and second inputdevices; a memory; and a controller configured to control themultiple-degree freedom slave arm so that the multiple-degree freedomslave arm is operated by one of the first input device and the secondinput device, wherein the controller is configured to: when anin-operation signal is not turned on, allow the multiple-degree freedomslave arm to be operated by the first input device in a teaching modethat is a mode for setting a fulcrum position; set the fulcrum positionand store the fulcrum position in the memory when the third input deviceis operated in the teaching mode; and when the in-operation signal isturned on, control the multiple-degree freedom slave arm so as to move adistal end portion of the surgical instrument to spatial coordinatesinstructed by the second input device while maintaining a state wherethe surgical instrument passes through the set fulcrum position.

In accordance with an aspect, a surgery system comprising: amultiple-degree freedom slave arm, which is able to be mounted with amedical instrument and includes a plurality of joints and a plurality ofmotors corresponding the respective joints of the plurality of joints; afirst input device configured to operate the multiple-degree freedomslave arm; a second input device configured to operate themultiple-degree freedom slave arm and different from the first inputdevice; a touch panel configured to display information related to anoperation of the multiple-degree freedom slave arm by the first inputdevice; a memory storing a fulcrum position; and a controller configuredto control the multiple-degree freedom slave arm so that themultiple-degree freedom slave arm is operated by one of the first inputdevice and the second input device, wherein the controller is configuredto: when an in-operation signal is not turned on, control the touchpanel to display the information and allow the multiple-degree freedomslave arm to be operated by the first input device; and only when thein-operation signal is turned on, control the multiple-degree freedomslave arm so as to move a distal end portion of the medical instrumentto spatial coordinates instructed by the second input device whilemaintaining a state where the medical instrument passes through thefulcrum position.

Other characteristics and advantages of the present disclosure will beclear in the following descriptions with reference to the accompanyingdrawings. Note that, the same reference numerals and signs will beapplied to the same or similar configurations in the accompanyingdrawings.

BRIEF DESCRIPTION OF THE DRAWINGS

Description includes the accompanying drawings, which are configured tobe a part thereof, illustrate exemplary embodiments of the presentdisclosure, and are applied to explain principles of the presentdisclosure together with the description thereof.

FIG. 1 is a diagram illustrating a configuration of a remoteoperation-type surgery system in accordance with an exemplaryembodiment.

FIGS. 2A and 2B are diagrams illustrating a slave arm in accordance withan exemplary embodiment.

FIG. 3 is a diagram illustrating a master arm in accordance with anexemplary embodiment.

FIG. 4 is a block diagram illustrating a configuration example of arobot controller in accordance with an exemplary embodiment.

FIG. 5 is a flow chart illustrating a support operation for laparoscopicsurgery conducted through remote operation in accordance with anexemplary embodiment.

FIG. 6A is a flow chart illustrating a posture alignment operation inaccordance with an exemplary embodiment.

FIG. 6B is a flow chart illustrating another posture alignment operationin accordance with an exemplary embodiment.

FIG. 7 is a flow chart illustrating an insertion operation in accordancewith an exemplary embodiment.

FIG. 8 is a flow chart illustrating driving processing of the slave armwhile a trocar is under restriction in accordance with an exemplaryembodiment.

FIGS. 9A and 9B are diagrams illustrating the posture alignmentoperation of the slave arm in accordance with an exemplary embodiment.

FIG. 10 is a diagram illustrating operations of the master arm and theslave arm while the trocar is under restriction.

DETAILED DESCRIPTION

Hereinafter, an example according to an exemplary embodiment of thepresent disclosure will be described with reference to the accompanyingdrawings.

FIG. 1 is a diagram illustrating an example of a remote operation-typesurgery system in the embodiment. In the configuration illustrated inFIG. 1 , a slave arm 21 which is a multiple-degree freedom robot armoperates following after movement of a master arm 31. As an operatoroperates the master arm 31, minimally invasive surgery such aslaparoscopic surgery can be realized by performing remote operation.

In accordance with an exemplary embodiment, a robot controller 11controls driving of each of axes of the slave arm 21. Operationinterfaces such as a teaching pendant 12, a touch panel display 13, anda keyboard 14 can be connected to the robot controller 11, as necessary.The teaching pendant 12 instructs the robot controller 11 to perform ajog operation of the slave arm 21 in accordance with a user's operation.The touch panel display 13 displays various operation states of theslave arm 21 and provides a graphical user interface for performingvarious operational instructions. The keyboard 14 is applied to inputvarious items of data into the robot controller 11. For example, a userapplies the keyboard 14 so as to be able to input a coordinate value ofa teaching position for the slave arm 21 and to make an instruction forthe jog operation. Note that, in accordance with an exemplaryembodiment, the jog operation denotes an operation in which a robot isguided at a predetermined speed in a predetermined direction or therobot in a predetermined axis is driven at a predetermined speed throughthe operation interfaces such as the teaching pendant 12, the touchpanel display 13, and the keyboard 14 by performing an ON/OFF operationor the like with buttons.

As the slave arm 21, for example, a six-axis vertical articulated robotarm can be applied, and which is generally used as an industrial robot.Forceps 22 for conducting the laparoscopic surgery can be mounted at adistal end portion of the slave arm 21. Note that, the degree of freedomof the slave arm 21 is not limited to six axes, and disposition of thedegree of freedom is not limited as well. However, there is a need tohave the degree of freedom to the extent in which operations required inthe laparoscopic surgery can be realized, and disposition of the degreeof freedom. The slave arm 21 will be described later in detail withreference to FIGS. 2A and 2B.

The forceps which have been mounted in a surgery robot can bemultiple-degree freedom forceps, which include yaw axis-roll axis orpitch axis-yaw axis-gripper axis for the distal end portion. A grippercan be guided to be positioned in arbitrary position and posture insidean abdominal cavity. However, the surgery robot is not necessarily to bethe multiple-degree freedom forceps. Therefore, in this disclosure,detailed descriptions will not be particularly given regarding thedegree of freedom of the distal end portion of the forceps. Meanwhile,when exhibiting surgical techniques, it can be natural that endeffectors in any form such as a gripper, scissors, an L-shaped hook, anelectrical scalpel, and an energy device are necessary regardless of thepresence or absence of an articulation of the distal end portion or thedegree of freedom of the end effectors. In addition, it is possible tohave a configuration as an endoscope retention arm by causing the arm toretain an endoscope (an endoscope such as a laparoscope, a thoracoscope,a hysteroscope, and a nasoscope, with which the inside of a human bodycan be observed).

The master arm 31 can provide an operation unit with which an operatorinstructs the slave arm 21 to make a movement of the forceps 22. Acoordinate output device 32 outputs a spatial position instructedthrough the master arm 31 to the robot controller 11 as athree-dimensional coordinate value. Note that, the coordinate outputdevice 32 may have been built in the robot controller 11. Theconfiguration of the master arm 31 and the coordinate value output bythe coordinate output device 32 will be described later in detail withreference to FIG. 3 . A foot switch 33 outputs an in-operation signal tothe robot controller 11. The in-operation signal indicates a state ofeffectiveness or ineffectiveness of an operation performed by the masterarm 31. Note that, the configuration for generating such an in-operationsignal is not limited to the foot switch. For example, it is acceptableas long as an in-operation signal is output in accordance with a user'soperation other than the user's operation for designating the spatialposition of the forceps 22. For example, a holding portion of the masterarm 31 may be provided with an ON-OFF switch for the in-operationsignal.

A camera 41 images the inside of an abdominal cavity of a patient andtransmits an image signal thereof to a camera controller 42. The cameracontroller 42 causes a monitor 43 to display the image signal receivedfrom the camera 41. An operator can conduct surgery by operating themaster arm 31 while checking a position of the forceps 22 inside theabdominal cavity moved by the slave arm 21, positions of internal organs(target lesion) of a patient, and the like through the monitor 43.Accordingly, the operator can conduct surgery under an environmentsimilar to that of general laparoscopic surgery.

FIGS. 2A and 2B are diagrams illustrating the slave arm 21 in thepresent exemplary embodiment. As described above, the slave arm 21 is asix-axis articulated arm, which can include a first axis, a second axis,and so forth to a sixth axis in order from the side of a base 201, asillustrated in FIG. 2A. For example, each of the axes is rotativelydriven by a servo motor. FIG. 2B schematically shows each of the axesand the arm of the slave arm 21. The reference numerals and signs θ1 toθ6 respectively indicate rotary angles (positions) around each of theaxes from the first axis to the sixth axis.

A position of the distal end portion of the forceps 22 is represented bythree-dimensional coordinates (x, y, and z), and a posture of theforceps 22 is represented by angles (Rx, Ry, and Rz) around the axes x,y, and z, for example. The position and the posture of the forceps 22are uniquely determined to be the factors (x, y, z, Rx, Ry, and Rz), andeach of the angles (θ1, θ2, θ3, θ4, θ5, and θ6) of the axes from thefirst axis to the sixth axis for realizing the position and the posturethereof is calculated by inverse kinematics computation. In addition,the position and the posture (x, y, z, Rx, Ry, and Rz) of the forceps 22can be obtained by forward kinematics computation based on each of theangles (θ1, θ2, θ3, θ4, θ5, and θ6) of the axes from the first axis tothe sixth axis.

A forceps mounting portion 202 is provided at the distal end portion ofthe slave arm 21, and the forceps 22 are mounted therein. The forceps 22can be configured to be suitably replaced in accordance with techniquesby being configured to be attachable and detachable with respect to theforceps mounting portion 202. Here, if the sixth axis (a rotary axis) iscaused to coincide with a shaft of the forceps 22 (a forceps shaft),that is, a major axis of the forceps 22, a rotative operation of theforceps shaft can be realized by driving only the sixth axis, therebybeing convenient. In accordance with an exemplary embodiment, forexample, the forceps shaft can rotate without moving the first axis tothe fifth axis, and the arm does not move in its entirety when theforceps shaft rotates. Therefore, a risk of interference with other armscan be reduced when multiple slave arms are installed, and thus, a driverange of the articulation can be moderated or an operation speed of thearticulation can be limited. In addition, positioning of an end effectorcan be performed at the distal end portion of the forceps inside anabdominal cavity of a patient and the end effector can be rotated aroundthe forceps shaft by providing the end effector such as a gripper axisand the like at the distal end portion of the forceps, and thus, generaltechniques related to the laparoscope can be realized.

FIG. 3 is a diagram illustrating the master arm 31 in accordance with anexemplary embodiment. The master arm 31 can include a master forcepshandle 301, a master forceps shaft 302, a virtual trocar portion 303, abase 304, and a position transmission mechanism 306. The master forcepshandle 301 is a portion to be held by an operator to operate the masterforceps shaft 302. When the forceps 22 includes a drive unit for drivingthe gripper, or an articulation axis or the like at the distal endportion of the forceps, a user interface for operating the drive unitthereof may be provided in the master forceps handle 301.

The master forceps shaft 302 can be supported in two axes by the virtualtrocar portion 303 so as to be rotatable with respect to the base 304and is supported so as to be cylindrically slidable. On account of thetwo-axis rotative support, the master forceps shaft 302 is supported soas to be able to perform a rotation 311 around the vertical axis and arotation 312 around the horizontal axis. In addition, on account of thecylindrical sliding support, the master forceps shaft 302 is supportedso as to be able to perform sliding in a shaft axis direction 313 and arotation 314 of the shaft.

According to the above-described configuration, an operator can move adistal end portion 305 of the master forceps shaft 302 to an arbitraryposition in a three-dimensional space. When the position transmissionmechanism 306 has a configuration similar to that of the six-axisvertical articulated robot arm, the position of the distal end portion305 in a three-dimensional space (the spatial position) is transmittedto the coordinate output device 32 via the position transmissionmechanism 306, and thus, the coordinate output device 32 can output thecoordinate values (x, y, and z) corresponding to the three-dimensionalposition thereof to the robot controller 11. Note that, a rotary angle(r) of the rotation 314 of the shaft is also output to the robotcontroller 11 via the coordinate output device 32.

In addition, the spatial position of the shaft to be detected is notlimited to the distal end portion 305. It is acceptable as long as thespatial position is for a particular portion of the shaft which isoperated by a user. However, it can be desirable to provide the virtualtrocar portion 303 between a portion (the master forceps handle 301)with which a user holds the master forceps shaft 302 and the particularportion of which the spatial position is detected. In addition, a sensormay be disposed for the two-axis rotative support (the vertical axis andthe horizontal axis) of the virtual trocar portion 303 and thecylindrical sliding support (a forceps insertion direction and therotary axis around the forceps shaft) so as to detect a position of theparticular portion of the master forceps shaft 302. According to such aconfiguration as well, the position of the distal end portion 305 in athree-dimensional space (the spatial position: the coordinate values (x,y, and z) corresponding to the three-dimensional position) and therotary angle (r) of the rotation 314 of the shaft can be output to therobot controller 11.

In accordance with an exemplary embodiment, an operator holds the masterforceps handle 301 and operates the master forceps shaft 302 which issupported by the virtual trocar portion 303 while watching the monitor43, thereby conducting surgery in which the forceps 22 mounted in theslave arm 21 is applied. In this manner, since the master forceps shaftsupported by the virtual trocar portion 303 is operated, surgeryconducted through remote operation can be realized with feeling ofoperation similar to that of operation of forceps performed duringconventional laparoscopic surgery. Moreover, the forceps can be operatedin an optimal posture and easy to operate the forceps at all timeswithout operating the forceps in a tough posture over a surgical tableand without being interfered with an assistant doctor.

FIG. 4 is a block diagram illustrating a configuration example of therobot controller 11. The robot controller 11 can include a control unit410, a memory 420, an external interface (an external I/F) 430, and aservo driver 440. The control unit 410 can include a CPU, a ROM, a RAM,and the like (not illustrated) and functions as a teaching processingsection 411, a posture alignment processing section 412, an insertionevulsion processing section 413, a restriction operation processingsection 414, and a coordinate processing section 415 so as to realizeeach step of the below-described processing. For example, as the CPUexecutes a program stored in the ROM or the RAM, each of the processingsections can be realized. Operations of each of the processing sectionsin detail are disclosed through the following descriptions.

For example, the memory 420 is a secondary storage device which isconfigured to be a hard disk, a semiconductor memory, or the like andcan include a trocar position retention section 421, an insertion startposition retention section 422, a standby position retention section423, and a forceps table 424. The trocar position retention section 421retains coordinates of a position (a trocar position) at which theforceps is inserted into a human body of a patient during laparoscopicsurgery, and an insertion posture thereof. The trocar position and theinsertion posture are standards for a spatial position(three-dimensional coordinates) of a trocar so as to insert the forceps22 into an abdominal cavity, and an insertion direction of the forceps22 into the trocar. In accordance with an exemplary embodiment, a usercan designate the trocar position and the insertion posture byperforming a teaching operation while being under the control of theteaching processing section 411.

In accordance with an exemplary embodiment, for example, the trocar canbe configured to include a forceps insertion portion (an openingportion), and a tubular portion which is inserted through an abdominalwall. However, the trocar position mentioned herein is a position in thevicinity into which the tubular portion has been inserted in theabdominal wall portion, that is, the vicinity of an intersection pointbetween the abdominal wall portion and the tubular portion. The trocarposition denotes a position of a fulcrum (a steady point) when theforceps shaft is inserted into an abdominal cavity.

The trocar position retention section 421 can retain the insertionpostures corresponding to a plurality of the trocar positions. A desiredtrocar position can be selected from the plurality of trocar positionsas a user performs inputting through the touch panel display 13 or thekeyboard 14. The insertion start position retention section 422 retainsa starting position and a posture of an insertion operation when theforceps 22 are inserted toward the selected trocar position. The standbyposition retention section 423 retains a position and a posture of theslave arm 21 in a standby state, and a user can mount and replace theforceps 22 at the position. The types of the forceps, lengths of theforceps shaft, and forceps coordinate systems have been correspondinglyrecorded in the forceps table 424. The forceps coordinate system can bedefined by a standard position of the slave arm, for example, theposition and the posture with respect to a mechanical interface.

The servo driver 440 controls driving of the servo motors correspondingto the first axis to the sixth axis of the slave arm 21. The controlunit 410 instructs the servo driver 440 of an amount of driving of eachof the axes or acquires rotary positions (θ1 to θ6) of each of the axes.The teaching pendant 12, the touch panel display 13, the keyboard 14,the coordinate output device 32, and the foot switch 33 are connected tothe external I/F 430. In accordance with an exemplary embodiment forexample, when the distal end portion of the forceps includes thearticulation axis or the gripper axis, a servo driver for driving thearticulation axis or the gripper axis at the distal end portion of theforceps may be added inside the servo driver 440.

Subsequently, descriptions will be given regarding an operation of theremote operation-type surgery system in the present embodiment includingthe above-described configuration. FIG. 5 is a flow chart illustratingan operation of the robot controller 11 in the present exemplaryembodiment in a laparoscopic surgery mode.

In the laparoscopic surgery, first, there is a need to cause the robotcontroller 11 (the trocar position retention section 421) to store thetrocar position, which is a forceps insertion position with respect toan abdominal cavity of a patient, and the insertion posture, which isthe insertion direction for the forceps through teaching. When ateaching mode is designated through the user interface (hereinafter,referred to as GUI, not illustrated) which is provided by the touchpanel display 13, the teaching processing section 411 executes theteaching processing of Step S501. Then, teaching results (vectorsindicating the three-dimensional coordinate value and the insertiondirection) of the trocar position and the insertion posture are retainedin the trocar position retention section 421.

In teaching of the trocar position and the insertion posture, forexample, the slave arm 21 is moved by an operation of the teachingpendant 12 or in a manual manner, the distal end portion of the forceps22 is caused to coincide with the forceps insertion position of apatient, and the insertion posture of the forceps 22 is adjusted. Then,the GUI is operated in the aforementioned state, thereby making aninstruction of a determined result. In accordance with the instruction,the teaching processing section 411 calculates the three-dimensionalcoordinates (x, y, and z) of the distal end portion of the forceps 22based on the rotary angle (θ1 to θ6) of each of the axes and the lengthof the mounted forceps 22 (the forceps coordinate system) at the momentthereof, and the calculated result is retained in the trocar positionretention section 421. In addition, the vectors, for example, (Rx, Ry,and Rz) indicating axial directions of the forceps 22 are calculated,and the calculated result is retained in the trocar position retentionsection 421 as the insertion posture. Note that, (Rx, Ry, and Rz)indicate the rotary angles around the axes x, y, and z. Note that, amethod of teaching the trocar position or the insertion posture is notlimited thereto. The three-dimensional coordinates or the insertionposture of the forceps insertion position may be input by using thekeyboard 14. In addition, the length of the mounted forceps 22 (theforceps coordinate system) can be acquired from the forceps table 424 inaccordance with the type of the forceps 22 input by a user. Note that,acquisition of the length of the forceps 22 is not limited to theabove-described method. The length of the mounted forceps 22 may bedirectly input by using the keyboard 14.

Moreover, in accordance with an exemplary embodiment, the length of theforceps 22 may be acquired through a position and posture measurementsystem in which three-dimensional position and posture of the trocar canbe acquired with respect to a base coordinates system of a robot, or aworld coordinate system (the base coordinates system of a robot can bedefined with respect to the world coordinate system). In addition, it isacceptable as long as the data to be acquired is basically thethree-dimensional position of the trocar. However, as postureinformation is also acquired, the posture information can be utilizedwhen determining whether or not the forceps insertion direction isappropriate, or the like (will be described later). Thus, a safer systemcan be established. In addition, even when a position at which a movablearea of the slave arm 21 exceeds a permissible range for insertion withrespect to each of the trocar positions cannot be taken, there is noneed to control the insertion posture with respect to the trocarposition.

Subsequently, when an instruction for a shift to the insertion postureis made via the GUI, the posture alignment processing section 412 movesthe slave arm 21 to the insertion posture in Step S502. The insertionposture is a posture in which the major axis of the forceps 22 (theforceps shaft) is coincided on a straight line passing through thedistal end portion of the forceps 22 and the trocar position. If theposture is included in a predetermined range (the permissible range)having a direction indicated by the insertion posture which has beenstored in the trocar position retention section 421 while beingcorresponding to the trocar position, as a standard, it is consideredthat posture alignment with respect to the insertion posture has beencompleted. As the posture alignment with respect to the insertionposture ends, the forceps 22 move in the major axis direction of theforceps 22 in a parallel manner, and then, the forceps 22 is insertedinto an abdominal cavity of a patient from the trocar position. Inaccordance with an exemplary embodiment, for example, when the directionof the forceps 22 in a result of the posture alignment processing is notincluded within the permissible range, a user can be notified of such afact.

In the present exemplary embodiment, the posture alignment processingfor the slave arm 21 with respect to the insertion posture can includefour modes as described below.

Automatic Mode: The slave arm 21 is moved to the insertion posture inwhich the distal end portion of the forceps 22 coincides with thethree-dimensional position retained in the insertion start positionretention section 422 through an articulation synchronous operation or alinear interpolation operation of the first axis to the fifth axis.

Articulation Synchronous Operation Mode: The first to third axes arefixed, and the posture alignment is performed so as to cause the trocarposition to match the major axis direction of the forceps 22 through anarticulation synchronous operation of the fourth and fifth axes.

Jog Operation Mode: The first to third axes are fixed, and the posturealignment is performed so as to cause the trocar position to match themajor axis direction of the forceps 22 through a jog operation of thefourth and fifth axes.

Manual Mode: The first to third axes are fixed, and the posturealignment is performed so as to cause the trocar position to match themajor axis direction of the forceps 22 through a manual operation of thefourth and fifth axes.

In accordance with an exemplary embodiment, for example, in theoperation modes described above, the sixth axis is not directly engagedwith the insertion posture. However, the sixth axis may be included inthe modes when a posture of the end effector (a shaft rotary axis) needsto be restricted. In addition, when a forceps distal end articulationaxis or the gripper axis is included, the axes need to be guided to aninsertable posture (for example, the pitch axis and the yaw axis are ina straight state in the same direction as the shaft, and the gripper isin a closed state) at the same time, before, or after the posturealignment processing. In accordance with an exemplary embodiment, forexample, as a method of teaching of the insertion posture for theforceps distal end articulation axis or the gripper axis, the guidancecan be considered through the automatic operation, the JOG operation, orthe manual operation, similar to the slave arm 21.

In addition, when the forceps shaft rotary axis and the sixth axis donot coincide with each other, since a posture for the posture alignmentcannot be uniquely determined with only the fourth and fifth axes, thereis a need to make determination including a posture of the forceps shaftrotary axis. In such a case, the automatic mode for the automaticoperation performed by the first to sixth axes is applied. In addition,in the articulation synchronous operation mode, the jog operation mode,and the manual mode in which the first to third axes are fixed, when thedirection of the forceps 22 is out of the above-described permissiblerange as a result of the posture alignment processing, a user may beurged to make an instruction of the posture alignment processing to beperformed through the automatic mode.

Hereinafter, the posture alignment processing according to the presentembodiment will be described further with reference to FIGS. 6A and 6B.First, in accordance with an instruction for a shift to the insertionposture, the posture alignment processing section 412 reads out thetrocar position from the trocar position retention section 421 (StepS601). When the plurality of trocar positions have been retained in thetrocar position retention section 421, a user is caused to select adesired trocar position through the GUI. Otherwise, the trocar positionat the time of insertion or evulsion in the previous stage is stored,and the trocar position may be applied as a default position.Hereinafter, the three-dimensional coordinates of the designated trocarposition at which the forceps 22 is inserted are referred to as (xt, yt,and zt).

When the automatic mode has been selected, the processing proceeds fromStep S602 to Step S603. In Step S603, the posture alignment processingsection 412 reads out an insertion start position from the insertionstart position retention section 422. When a plurality of the insertionstart positions have been retained in the insertion start positionretention section 422, a user is caused to select a desired insertionstart position through the GUI. Otherwise, the position at the time ofinsertion or evulsion in the previous stage may be stored so as to beapplied as a default position for the insertion start position.Hereinafter, the three-dimensional coordinates of the read out orselected insertion start position are referred to as (xs, ys, and zs).Note that, it can be considered that a position away from the trocarposition by, for example, approximately 50 mm to 100 mm along theinsertion direction can be automatically calculated and retained in theinsertion start position retention section 422. In this case, a user maybe allowed to designate a clearance from the trocar position. Otherwise,a user may manually input the insertion start position (thethree-dimensional coordinates) with respect to the trocar position. Inthis case, it is determined whether or not the insertion start positiondesignated by a user is included within the permissible range having theinsertion direction corresponding to the trocar position, as a standard,and when the designated insertion start position is out of thepermissible range, a user may be urged to reset the insertion startposition.

In Step S604, the posture alignment processing section 412 calculates adirection of a vector passing through the trocar position (xt, yt, andzt) and the insertion start position (xs, ys, and zs) as the rotaryangle (Rxs, Rys, and Rzs) for the axes x, y, and z, for example. Thedirection of a vector may be expressed through other methods in whichthe direction can be expressed as a posture. Then, the posture alignmentprocessing section 412 determines the position and the posture of theforceps 22 (xs, ys, zs, Rxs, Rys, and Rzs) in which the direction of thevector and the major axis direction of the forceps 22 are combined, asthe insertion posture. In Step S605, the posture alignment processingsection 412 moves the slave arm 21 to the insertion posture, which hasbeen determined in Step S604. As the movement is completed, theprocessing proceeds to Step S641, and a user is notified of thecompletion of the posture alignment with respect to the insertionposture via the GUI.

When the insertion start position retention section 422 retains not onlythe insertion start position (xs, ys, and zs) but also the insertionstart position and the posture (xs, ys, zs, Rxs, Rys, and Rzs) includingthe posture, guidance may be directly performed to the insertion startposition and the posture (xs, ys, zs, Rxs, Rys, and Rzs) through thearticulation synchronous operation or the linear interpolationoperation. In this case, for example, processing of Step S604 can beomitted.

FIG. 9A illustrates a state of the posture alignment operation performedin the automatic mode in accordance with an exemplary embodiment. Adistal end portion 901 of the forceps 22 in arbitrary position andposture (x, y, z, Rx, Ry, and Rz) move to the insertion posture (xs, ys,zs, Rxs, Rys, and Rzs) through synchronous operations of each of theaxes. In the insertion posture, the major axis of the forceps 22coincides with a vector 903 in a direction in which the distal endportion 901 of the forceps 22 and a trocar position 902 are connected toeach other.

Note that, there may be additionally provided a function for determiningwhether an operation thereafter can be safely conducted when theinsertion posture (xs, ys, zs, Rxs, Rys, and Rzs) is derived. Forexample, it is calculated whether or not the insertion posture (xs, ys,zs, Rxs, Rys, and Rzs) is the position and the posture which a slaverobot can take (whether or not the insertion posture is within anoperational range of each articulation, or whether or not the insertionposture deviates from the operational range in the middle of theoperation), whether or not the trocar (a patient) and the forcepsinterfere with each other or are too close to each other, whether or notthe forceps can be inserted after the posture alignment operation(whether or not the insertion posture is within an operational range ofeach articulation, or whether or not the insertion posture deviates fromthe operational range in the middle of the operation), or the like.Then, as a result of the calculation, when it is determined that theoperation thereafter cannot be safely conducted, a notice or a warningmay be indicated for a user.

Meanwhile, in a case of other than the automatic mode, the processingproceeds from Step S602 to Step S606. In Step S606, the posturealignment processing section 412 fixes the first axis to the third axis(servo lock). Subsequently, in Step S607, the posture alignmentprocessing section 412 calculates target positions (angles) of thefourth axis and the fifth axis. While causing current rotary angles ofthe first axis to the third axis to be immovable, the target positions(the angles) of the fourth axis and the fifth axis are calculated so asto cause the major axis of the forceps 22 to coincide with the directionof the vector, which connects the position of the forceps mountingportion 202 and the trocar position. For example, as illustrated in FIG.9B, rotation amounts (the rotary positions) of the fourth axis and thefifth axis for moving the forceps mounting portion 202 so as to causepositions, such as a position of the forceps mounting portion 202, aposition of the distal end portion 901, and a position of the trocarposition 902 to be on a straight line are calculated.

In Step S608, the posture alignment processing section 412 determineswhich among the articulation synchronous operation mode, the jogoperation mode, and the manual mode is the mode of the posture alignmentprocessing. In a case of the articulation synchronous operation mode,the processing proceeds to Step S611. In Step S611, the posturealignment processing section 412 drives the fourth axis and the fifthaxis of the slave arm 21 and moves the forceps mounting portion 202 (thedistal end portion 901 of the forceps 22) to the target position whichhas been calculated in Step S607, through the articulation synchronousoperation. When the movement to the target position ends, in Step S612,the posture alignment processing section 412 fixes the fourth axis andthe fifth axis (servo lock), and notifies a user of the completion ofthe posture alignment in Step S641 via the GUI. In this manner, asillustrated in FIG. 9B, as the posture alignment processing drives thefourth axis and the fifth axis, the slave arm 21 moves to the insertionposture in which the vector 903 in the direction in which the distal endportion 901 of the forceps mounting portion 202 and the trocar position902 are connected to each other coincides with the major axis directionof the forceps 22.

When the mode is the jog operation mode, the processing proceeds fromStep S608 to Step S621. In Step S621, the posture alignment processingsection 412 performs the jog operation for the fourth axis and the fifthaxis in accordance with an input for operating the teaching pendant 12.In this case, the posture alignment processing can be efficientlyexecuted by prohibiting the jog operation in a direction of being awayfrom the target position, which has been calculated in Step S607. InStep S622, when there is an axis which has reached the target position,the posture alignment processing section 412 fixes the axis (servolock). The jog operation is prohibited for the fixed axis. In Step S623,the posture alignment processing section 412 determines whether or notboth the fourth axis and the fifth axis have been fixed to the targetposition. The processing returns to Step S621 unless at least one of theaxes has reached the target position. If both the axes have reached andbeen fixed to the target position, the processing proceeds to Step S641,and the posture alignment processing section 412 notifies a user of thecompletion of the posture alignment via the GUI. The state of theoperation of the slave arm 21 at the moment is as described above and asshown in FIG. 9B.

When the mode is the manual mode, the processing proceeds from Step S608to Step S631. In Step S631, the posture alignment processing section 412controls the fourth axis and the fifth axis so as to be able to be movedby an external force which a manipulator applies manually. In this case,the posture alignment processing can be efficiently executed bycontrolling the servo motor so as not to be manually moved in adirection of being away from the target position. In Step S632, whenthere is an axis which has reached the target position, the posturealignment processing section 412 fixes the axis (servo lock).Accordingly, the manual operation cannot be performed with respect tothe fixed axis. In Step S633, the posture alignment processing section412 determines whether or not both the fourth axis and the fifth axishave been fixed to the target position. The processing returns to StepS631 unless at least one of the axes has reached the target position. Ifboth the axes have reached and been fixed to the target position, theprocessing proceeds to Step S641, and the completion of the posturealignment is notified to a user via the GUI. The state of the operationof the slave arm 21 at the moment is as described above and illustratedin FIG. 9A.

Note that, in Step S641, it is determined whether or not the directionof the forceps 22 of which the posture alignment has been completed iswithin the permissible range having the insertion direction which hasbeen retained in the trocar position retention section 421 while beingcorresponding to the trocar position, as a standard, and when thedirection is out of the permissible range, a warning to the effectthereof is issued. In this case, together with a warning to the effectof being out of the permissible range, for example, a user may be urgedto execute the posture alignment in the automatic mode. In addition, itmay be determined whether or not the direction of the forceps 22 afterthe posture alignment has been performed is within the above-describedpermissible range at the time when the target position is calculated inStep S607 described above. In this case, if the insertion direction isout of the permissible range, a warning can be issued to the effectthereof and the operation can be prohibited from being executed in thearticulation synchronous operation mode, the jog operation mode, and themanual mode.

Returning to FIG. 5 , when the posture alignment performed by theposture alignment processing section 412 is completed, the processingproceeds to Step S503. In Step S503, when an instruction is giventhrough the GUI so as to insert the forceps 22 (instruction ofinsertion), the insertion evulsion processing section 413 drives theslave arm 21 so as to cause the forceps 22 to move in a parallel manneralong the major axis direction thereof, and inserts the forceps 22 intoan abdominal cavity of a patient from the trocar position.

FIG. 7 is a flow chart illustrating an insertion operation of theforceps 22. When an instruction of insertion is received through the GUIin Step S701, the insertion evulsion processing section 413 controlsdriving of each of the axes of the slave arm 21 so as to cause theforceps 22 to move along the major axis direction (the direction of thevector 903 in FIGS. 9A and 9B) of the forceps 22 in Step S702. Since theposture alignment of the forceps 22 has been completed by the posturealignment processing section 412 as described above, the forceps 22advances toward the trocar position on account of a parallel movementperformed in Step S702. Note that, a safer system can be established bysuitably determining whether or not the forceps 22 advances toward thetrocar position. For example, the determination can be realized bycalculating misalignment (a distance) between a direction of the forcepsshaft and the trocar position. Since the direction of the forceps shaftcan be obtained as an equation of a straight line and the trocarposition can be obtained as a coordinate value, a distance between astraight line and a point (a vertical distance: a shortest distance) maybe obtained so as to determine that the forceps 22 is headed for thetrocar position when the distance is zero (or less than a predetermineddistance).

When the distal end portion of the forceps 22 passes through the trocarposition and advances to a predetermined depth, the processing proceedsfrom Step S703 to Step S704, and the insertion evulsion processingsection 413 stops the operation of the slave arm 21. Then, in Step S705,the insertion evulsion processing section 413 notifies a user of thecompletion of the insertion operation via the GUI. Otherwise, when thedistal end of the forceps 22 passes through the trocar position andadvances to a predetermined depth, the insertion evulsion processingsection 413 may be in a standby state until a user determines thecompletion of the insertion operation. In this case, a user inputsconfirmation of completion of the insertion operation via the GUI,thereby completing the insertion operation. It may be caused to suspendinsertion and to allow evulsion until a user inputs the confirmation ofcompletion.

Since the length of a tube portion of the trocar is equal to or lessthan approximately 100 mm in general, in consideration of the regions ofthe tube portion inside an abdominal cavity and the tube portion outsidethe abdominal cavity, a state of being inserted to the depth of, forexample, approximately 50 mm may be considered to be the state of beinginserted to a predetermined depth. In accordance with an exemplaryembodiment, for example, an insertion amount may be set to, for example,approximately 10 mm. In consideration that the length of the forcepsshaft ranges, for example, from approximately 300 mm to 400 mm, a stateof being inserted to the depth ranging, for example, from approximately30 mm to 40 mm may be set as the state of being inserted to apredetermined depth. After the completion of insertion, a trocarrestriction operation can be performed (shifted to a state having arestriction operation), that is, the forceps 22 is operated whilemaintaining a state of passing through the trocar position.

Returning to FIG. 5 , as the insertion operation has completed, theprocessing proceeds from Step S504 to Step S505. In Step S505, therestriction operation processing section 414 causes the slave arm 21 tofollow the operation of the master arm 31 while the trocar is underrestriction based on the three-dimensional position from the coordinateoutput device 32 and the in-operation signal from the foot switch 33.When the trocar is under restriction, the slave arm 21 is controlled soas to move the distal end portion of the forceps 22 to thethree-dimensional position which is designated by the master arm 31while the forceps 22 maintains the state of passing through the trocarposition. In addition, an operation of following the operation of themaster arm 31 can only be executed while the in-operation signal fromthe foot switch 33 is in an ON state.

Descriptions will be given regarding processing of an operation whilethe trocar is under restriction with reference to the flow chart in FIG.8 . In Step S801, the restriction operation processing section 414determines whether or not the in-operation signal from the foot switch33 is ON. When the in-operation signal is ON, the processing proceeds toStep S802. The coordinate processing section 415 acquires the coordinatevalue from the coordinate output device 32, and the acquired value isreferred to as previous coordinates (initial coordinates). Note that,the coordinate values acquired from the coordinate output device 32herein are the position (x, y, and z) corresponding to thethree-dimensional position of the distal end portion 305 of the masterforceps shaft 302, and the rotary angle (r) of the master forceps shaft302. When a predetermined sample interval elapses after the previouscoordinates have been acquired and sample timing is obtained, theprocessing proceeds from Step S803 to Step S804.

In Step S804, the coordinate processing section 415 acquires thecoordinate value from the coordinate output device 32 as currentcoordinates. Then, the coordinate processing section 415 calculates adifference between the previous coordinates and the current coordinates,and obtains a movement amount (Δx, Δy, and Δz) of the distal end portion305 of the master forceps shaft 302 and the rotation amount (Δr) of themaster forceps shaft 302 in the sample interval. Then, the movementamount and the rotation amount are output to the restriction operationprocessing section 414, which state is illustrated in FIG. 10 . Thecoordinate processing section 415 calculates a movement amount 100 ((Δx,Δy, and Δz) and (Δr)) of the distal end portion 305 caused by anoperation of the master arm 31.

Subsequently, in Step S805, the restriction operation processing section414 acquires the three-dimensional coordinates (xm, ym, and zm) of acurrent distal end portion position 1001 of the forceps 22 mounted inthe slave arm 21, based on the rotary position (01 to 05) of the firstaxis to the fifth axis and the length (forceps coordinates) of theforceps 22. Then, in Step S806, the restriction operation processingsection 414 calculates the three-dimensional coordinates (xn, yn, andzn) of a target distal end portion position 1002 based on the currentdistal end portion position 1001 (xm, ym, and zm), and the movementamount (Δx, Δy, and Δz) acquired from the coordinate processing section415. Moreover, the restriction operation processing section 414calculates a vector 1004 (Rxn, Ryn, and Rzn) in a direction in which thetarget three-dimensional coordinates (xn, yn, and zn) and a trocarposition 1000 are connected to each other. In this manner, the targetposition and posture (xn, yn, zn, xn, Ryn, and Rzn) of the forceps 22 inaccordance with the movement amount (Δx, Δy, and Δz) of the master arm31 are determined. As described above, the spatial position at adestination of the distal end portion of the forceps 22 is determined inaccordance with an operation amount (a variation amount) of the masterarm 31 caused by a user's operation.

In Step S807, the restriction operation processing section 414 moves theforceps 22 to the target position and posture while maintaining a statewhere the forceps 22 passes the trocar position 1000, that is, while thetrocar position is under restriction. Then, in Step S808, therestriction operation processing section 414 rotates the sixth axis inaccordance with the rotation amount (Δr) of the master forceps shaft302. In this manner, while the trocar position is under restriction, theforceps 22 moves to a position instructed by the master arm 31 and arotative operation of the forceps shaft instructed by the master arm 31is executed.

In accordance with an exemplary embodiment, for example, the processingof Step S808 can be executed simultaneously with that of Step S806.Accordingly, movement processing of the forceps 22 to the targetposition and posture can be executed more efficiently.

Note that, while the above-described trocar restriction operation isperformed, it is desirable that calculation processing for the targetposition and posture of the forceps 22 is executed, and it can bedesirable to check whether or not the forceps 22 have been inserted by apredetermined amount with respect to the trocar position (whether or notthe forceps 22 have been inserted further than the minimum insertionamount), which can be because the movement of the forceps mountingportion 202 becomes fast and an operation of each of the axes of theslave arm becomes extremely fast when the distal end portion of theforceps is guided at a predetermined speed in a state where theinsertion amount of the forceps is small. When an operation speed ofeach of the axes of the slave arm exceeds a predetermined speed, each ofthe articulations cannot follow a target value. As a result, there is apossibility that an operation in a state where the forceps shaftmaintains the trocar position cannot be performed. Therefore, in orderto help ensure a safe operation, there is a need to check whether theforceps have been inserted by a predetermined amount with respect to thetrocar position.

Then, when the target value is generated in a direction of evulsion froma state where the forceps 22 have been inserted by a predeterminedamount (the minimum insertion amount) with respect to the trocarposition, processing for causing the target value to return to theprevious target value (in a state where the forceps have been insertedby a predetermined amount with respect to the trocar position), or thelike is performed. According to such processing, the forceps 22 canmaintain a state of being inserted by equal to or greater than apredetermined amount with respect to the trocar position. In addition,it can be desirable that a manipulator is presented with a fact that thetarget value in the evulsion direction is generated from the state wherethe forceps have been inserted by a predetermined amount with respect tothe trocar, in a method in any form. In order to attain theaforementioned condition, the manipulator can be presented with the factby senses of force, hearing, or sight, for example.

Note that, during the insertion of the forceps described above, theaforementioned minimum insertion amount or an insertion amount greaterthan the minimum insertion amount is employed as a threshold value forthe determination at the time of a shift from Step S703 to Step S704,and thus, it is possible to smoothly shift to the state of controllingwhile the trocar is under restriction.

In addition, similar to that described above, since the length of thetube portion of the trocar is equal to or less than, for example,approximately 100 mm, in consideration of the regions of the tubeportion inside an abdominal cavity and the tube portion outside theabdominal cavity, the above-described minimum insertion amount may beset to, for example, approximately 50 mm. Naturally, if followability ofthe slave arm 21 can be sufficiently obtained, an insertion amount of,for example, approximately 10 mm may be set as the minimum insertionamount. In addition, in consideration that the length of the forcepsshaft ranges, for example, approximately from 300 approximately mm to400 mm, for example, approximately ten percent thereof, that is, forexample, a range approximately from 30 mm to 40 mm may be set as theminimum insertion amount. In this case, the minimum insertion amountvaries in accordance with the length of the mounted forceps.

Moreover, in accordance with an exemplary embodiment, the maximuminsertion amount may be designated so as to avoid a collision betweenthe forceps mounting portion of the robot (outside the forceps shaftportion) and the trocar, or to avoid unexpected contact or damage to theinternal organs caused by inserting the forceps further than necessary.In consideration that the length of the forceps shaft ranges, forexample, from approximately 300 mm to 400 mm, a state of being insertedto the depth ranging, for example, from approximately 250 mm to 300 mmcan be set as the maximum insertion amount. Naturally, in order to helpensure the operation region, the maximum insertion amount needs to beequal to or greater than the above-described predetermined insertionamount (the minimum insertion amount). When the target value in adirection of being inserted further than the maximum insertion amount isgenerated from the state where the forceps have been inserted by apredetermined amount with respect to the trocar, processing for causingthe target value to return to the previous target value (in a statewhere the forceps have been inserted by a predetermined amount withrespect to the trocar), or the like can be performed. Thus, the statewhere the forceps have been inserted by a predetermined amount withrespect to the trocar can be maintained. In addition, in accordance withan exemplary embodiment, it can be desirable that a manipulator ispresented with a fact that the target value in the insertion directionexceeding the maximum insertion amount is generated from the state wherethe forceps have been inserted by a predetermined amount with respect tothe trocar, in a method in any form. For example, the manipulator can bepresented with the fact by senses of force, hearing, or sight.

In Step S809, the coordinate processing section 415 retains the currentcoordinates acquired in Step S804, as the previous coordinates. Then,the processing returns to Step S803, and the above-described processingis repeated. When the in-operation signal is in an OFF state whilewaiting for successive sample timing, the processing returns to StepS801 from Step S810. In this manner, only while the in-operation signalis in an ON state by the foot switch 33, the slave arm 21 followsmovement of the distal end portion of the master arm 31. In theabove-described the embodiment, algorithm for generating the targetvalue is presented based on the relative movement amount of the previouscoordinates with respect to the previous coordinates for each sampling.However, naturally, coordinates at certain timing may be set as astandard (the initial coordinates) instead of generating for eachsampling. For example, the coordinates when the in-operation signal isON may be set as the initial coordinates, and while the in-operationsignal is ON, the target value may be generated based on the relativecoordinates from the initial coordinates.

Returning to FIG. 5 , when evulsion of the forceps 22 is instructed viathe GUI, the processing proceeds from Step S506 to Step S507. In StepS507, the insertion evulsion processing section 413 draws the forceps 22out of the patient's body along the major axis direction of the forceps22 at the moment. When the distal end portion of the forceps 22 passesthrough the trocar position and is away from the trocar position by apredetermined distance, an evulsion operation is completed (Step S508),and the forceps 22 wait for an instruction for moving to a standbyposition (Step S509). At this moment, the trocar restriction operationis cancelled. When a standby instruction is input through the GUI, theslave arm 21 moves to a predetermined standby position which has beenretained in the standby position retention section 423 (Step S509).

Here, in accordance with an exemplary embodiment, a function fordetermining whether the evulsion operation can be safely conducted maybe added. For example, it is calculated whether or not the insertionposture is the position and the posture which the slave robot can take(whether or not the insertion posture is within an operational range ofeach articulation, whether or not the insertion posture deviates fromthe operational range in the middle of the operation), or the like withrespect to the operation in which the distal end portion of the forceps22 passes through the trocar position and is away from the trocarposition by a predetermined distance, and when there is a possibilitythat the evulsion operation thereafter cannot be safely conducted, anotice or a warning may be clearly presented to a user.

Note that, as described above, the position and the posture of theforceps 22, and the trocar position at the time of completion of theevulsion operation in Step S507 may be retained as the insertion posturewhen the forceps insertion is performed in the automatic mode so as tobe utilized in the above-described posture alignment (Step S502). Inthis manner, for example, in a case or the like where the forceps arereinserted from the same trocar position after replacement of theforceps which has been used, the trocar position, and the insertionstart position and the posture can be simply selected, thereby beingconvenient. In addition, in this case, since the stored insertionposture is applied as it is, there is no need to calculate the insertionposture in Step S604.

Note that, there is a need to maintain a state where a shaft axis(hereinafter, referred to as the forceps shaft axis) of the forceps 22passes through the trocar position with no error or with an error equalto or less than a tolerance value in the operation while the trocar ofthe slave arm 21 is under restriction. It is because there is apossibility that excessive force is generated on an abdominal wall of apatient, thereby causing an occurrence of an unfavorable state when theerror is excessive. However, a state where the forceps shaft axis passesthe trocar position with no error is not necessarily able to bemaintained due to degradation of followability with respect to a targettrajectory of the slave arm at the time of a high-speed operation or ina peculiar posture and the vicinity of a so-called robot. Therefore,there is a need to derive a distance between the trocar position and theforceps shaft axis (for example, a vertical distance) and to monitorthat the distance is equal to or less than a predetermined amount. Inaddition, there is a need for a manipulator to be clearly indicated whenthe distance between the trocar position and the forceps shaft axis isin a state of being equal to or greater than a predetermined amount.Moreover, a safer system can be established by controlling the distanceto avoid being equal to or less than a predetermined amount when thedistance between the trocar position and the forceps shaft axis is equalto or greater than a predetermined amount, that is, by executingcontrolling such as slowing down the speed of the slave arm, stoppingthereof, or the like in a forcible manner, for example.

In addition, the movement amount (Δx, Δy, and Δz) of the master arm 31may be decreased or increased by the coordinate processing section 415so as to be reflected to movement of the forceps 22. It is possible toprevent the hands from shaking by decreasing the movement amount, thatis, by decreasing an operation (decreasing the movement amount of thedistal end of the forceps 22 caused by the slave arm 21 with respect tothe movement amount of the distal end portion 305 of the master forcepsshaft 302).

In addition, information indicating a relationship between an imagingdirection of the camera 41 and the position of the slave arm 21 may beinput to the coordinate processing section 415 so that the coordinateprocessing section 415 converts the movement direction indicated by themovement amount of the master arm 31 based on the relationship which hasbeen input. For example, the horizontal and vertical directions of animage in the monitor 43 can substantially coincide with the horizontaland vertical directions in operation of the master arm 31. In thismanner, the movement direction of the forceps 22 which has beendisplayed in the monitor 43 can substantially coincide with the movementdirection of the distal end portion of the master arm 31, therebyimproving operation characteristics for an operator.

In addition, since the master arm 31 can be installed at an arbitraryposition on account of a simple and compact structure, an operator canbe freed from a situation in which surgery has to be conducted in anunstable posture due to positions of a surgical table, a patient, anassistant, and the like, thereby being able to perform operation in anoptimal posture at all times.

In addition, in the embodiment described above, a coordinate system isnot particularly described. However, if the factors x, y, and z in theworld coordinate system are applied, it is advantageous when multipleslave arms are applied.

As described above, according to the embodiment described above, since asupport system for laparoscopic surgery can be established by applying aso-called industrial robot, it is inexpensive and it is possible toobtain a system which is excellent in flexibility with respect tooperation for an operator. For example, the trocar position can varywithout changing the installation position of the arm when being withinthe operation region of the industrial robot (the slave arm). Therefore,it is possible to flexibly cope with multiple trocar positions with oneslave arm.

In addition, in the embodiment described above, descriptions are giventhat the distal end of the forceps 22 is caused to match the spatialposition instructed by the master arm 31. However, the embodiment is notlimited thereto, and there is no need to mention that a predeterminedportion of the forceps 22 may be caused to match. For example, when thegripper is provided at the distal end portion of the forceps 22 and thegripper is configured to be rotatable around two rotary axes such as theroll axis and the yaw axis, the rotary portion of the gripper may be theportion to be caused to match the spatial position instructed by themaster arm 31.

Note that, in the embodiment described above, the end effector has beendescribed as the forceps. However, the embodiment is not limitedthereto, as described above. For example, the end effector may be anendoscope (the laparoscope and the thoracoscope) and other surgicalinstruments (an energy device and a treatment tool). In addition, in theembodiment described above, descriptions are given regarding an examplein which a medical manipulator is applied to surgery for the inside ofan abdominal cavity. However, there is no need to mention that theembodiment can be applied to surgery for a thoracoabdominal cavity, theinside of the skull, the inside of the heart, or the like. In accordancewith an exemplary embodiment, for example, any site may be subjectedthereto as long as the surgery is the minimally invasive surgery, whichcan be conducted by inserting a medical instrument into a human bodythrough a smaller insertion port and gives fewer burdens to the humanbody.

The detailed description above describes a medical manipulator and amethod of controlling the same in a remote operation-type surgerysystem. The invention is not limited, however, to the preciseembodiments and variations described. Various changes, modifications andequivalents can be effected by one skilled in the art without departingfrom the spirit and scope of the invention as defined in theaccompanying claims. It is expressly intended that all such changes,modifications and equivalents which fall within the scope of the claimsare embraced by the claims.

What is claimed is:
 1. A surgery system comprising: a multiple-degreefreedom slave arm, which is able to be mounted with a surgicalinstrument and includes a plurality of joints and a plurality of motorscorresponding the respective joints of the plurality of joints; a firstinput device configured to operate the multiple-degree freedom slavearm; a second input device configured to operate the multiple-degreefreedom slave arm and different from the first input device; and acontroller configured to control the multiple-degree freedom slave armso that the multiple-degree freedom slave arm is operated by one of thefirst input device and the second input device, wherein the controlleris configured to: when an in-operation signal is not turned on, allowthe multiple-degree freedom slave arm to be operated by the first inputdevice in a teaching mode that is a mode for setting a fulcrum position;and when the in-operation signal is turned on, control themultiple-degree freedom slave arm so as to move a distal end portion ofthe surgical instrument to spatial coordinates instructed by the secondinput device while maintaining a state where the surgical instrumentpasses through the set fulcrum position.
 2. The surgery system accordingto claim 1, wherein the second input device includes a master arm toremotely control the multiple-degree freedom slave arm and the firstinput device is other than the master arm.
 3. The surgery systemaccording to claim 1, wherein the first input device is a teach pendant,a touch panel, or a keyboard.
 4. The surgery system according to claim1, further comprising: a touch panel configured to provide a graphicaluser interface for displaying the fulcrum position.
 5. The surgerysystem according to claim 1, wherein the second input device comprises aswitch for turning on and off the in-operation signal.
 6. The surgerysystem according to claim 1, further comprising: a foot switch forturning on and off the in-operation signal.
 7. A surgery systemcomprising: a multiple-degree freedom slave arm, which is able to bemounted with a surgical instrument and includes a plurality of jointsand a plurality of motors corresponding the respective joints of theplurality of joints; a first input device configured to operate themultiple-degree freedom slave arm; a second input device configured tooperate the multiple-degree freedom slave arm and different from thefirst input device; a third input device different from the first andsecond input devices; a memory; and a controller configured to controlthe multiple-degree freedom slave arm so that the multiple-degreefreedom slave arm is operated by one of the first input device and thesecond input device, wherein the controller is configured to: when anin-operation signal is not turned on, allow the multiple-degree freedomslave arm to be operated by the first input device in a teaching modethat is a mode for setting a fulcrum position; set the fulcrum positionand store the fulcrum position in the memory when the third input deviceis operated in the teaching mode; and when the in-operation signal isturned on, control the multiple-degree freedom slave arm so as to move adistal end portion of the surgical instrument to spatial coordinatesinstructed by the second input device while maintaining a state wherethe surgical instrument passes through the set fulcrum position.
 8. Thesurgery system according to claim 7, wherein the second input deviceincludes a master arm to remotely control the multiple-degree freedomslave arm and the first and third input devices are other than themaster arm.
 9. The surgery system according to claim 7, wherein thefirst input device is a teach pendant, a touch panel, or a keyboard. 10.The surgery system according to claim 7, wherein the third input deviceis a touch panel configured to provide a graphical user interface forproviding an instruction to store the fulcrum position in the memory.11. The surgery system according to claim 7, wherein the graphical userinterface is configured to display the fulcrum position.
 12. The surgerysystem according to claim 7, wherein the second input device comprises aswitch for turning on and off the in-operation signal.
 13. The surgerysystem according to claim 7, further comprising: a foot switch forturning on and off the in-operation signal.
 14. The surgery systemaccording to claim 7, wherein the surgical instrument is a forcepsincluding a shaft, and the memory is configured to store a type of theforceps and a length of the shaft.
 15. A surgery system comprising: amultiple-degree freedom slave arm, which is able to be mounted with amedical instrument and includes a plurality of joints and a plurality ofmotors corresponding the respective joints of the plurality of joints; afirst input device configured to operate the multiple-degree freedomslave arm; a second input device configured to operate themultiple-degree freedom slave arm and different from the first inputdevice; a touch panel configured to display information related to anoperation of the multiple-degree freedom slave arm by the first inputdevice; a memory storing a fulcrum position; and a controller configuredto control the multiple-degree freedom slave arm so that themultiple-degree freedom slave arm is operated by one of the first inputdevice and the second input device, wherein the controller is configuredto: when an in-operation signal is not turned on, control the touchpanel to display the information and allow the multiple-degree freedomslave arm to be operated by the first input device; and only when thein-operation signal is turned on, control the multiple-degree freedomslave arm so as to move a distal end portion of the medical instrumentto spatial coordinates instructed by the second input device whilemaintaining a state where the medical instrument passes through thefulcrum position.
 16. The surgery system according to claim 15, whereinthe second input device includes a master arm to remotely control themultiple-degree freedom slave arm and the first input device is otherthan the master arm.
 17. The surgery system according to claim 15,wherein the touch panel is configured to provide a graphical userinterface for displaying the information including a selectableoperation modes, and the controller is configured to allow themultiple-degree freedom slave arm to be operated by the first inputdevice based on the selected operation mode.
 18. The surgery systemaccording to claim 15, wherein the second input device comprises aswitch for turning on and off the in-operation signal.
 19. The surgerysystem according to claim 15, further comprising: a foot switch forturning on and off the in-operation signal.
 20. The surgery systemaccording to claim 15, further comprising: a monitor, a cameraconfigured to image an inside of a patient and output an image signal,and a camera controller configured to cause the monitor to display theimage signal received from the camera.